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During the years that my mother was in a nursing home, I often fantasized about how it would be if I were in control. I would begin by reallocating funds, eliminating wasted time and money, and focusing on issues that are of real value to both staff and residents. I would revamp the current system to include nursing home employeesnurses, nurse aides, social workers, and so onwho are well educated, well trained, and well paid. This would allow for these individuals to operate under supportive circumstances that enable them to provide the dignified, compassionate, and skillful care that our elders deserve. To my fervent delight, I have discovered that an increasing number of people all over the United States are making this dream a reality. The nursing home reform movement is gaining what I believe will prove to be unstoppable momentum. Thanks to what was, at first, only a handful of visionaries, nursing homes scattered across the country are undergoing profound transformations. The people and facilities that are leading the way are showing that not only is it possible to deliver individualized, respectful care, but it also can be accomplished in an atmosphere that nurtures residents and employees alike. And the part that nursing home investors can relate to is that it doesn't have to cost a fortune to do so. Several leaders in nursing home reform have come together to form a coalition under the name Pioneers in Nursing Home Culture Change. Many of these people began their crusades as a result of working in nursing homes themselvesas doctors, nurses, social workers, and administrators. They each have focused, in their own unique ways, on developing creative responses to the nursing home dilemma. Their action plans overlap and interweave into a rich tapestry that reflects the diverse elements needed for a new paradigm of providing care for elders in our society. I first became aware of this quiet revolution when I read an article about a nursing home in upstate New York that was reported to be filled with potted plants, dogs, cats, birds, and childrenand responsive elderly people redeemed from the ranks of the living dead. This model of transforming a hospital-like nursing home into a homelike one is known as the Eden Alternative. Dr. William H. Thomas, a Harvard-educated medical doctor with a special concern for the elderly, spearheads this process that has converted hundreds of nursing homes into human habitats. More and more facilities throughout the United States are becoming "Edenized" every year. Naysayers who assume that such "radical" changes are impossible because of the expenses involved might be surprised to learn that this is not necessarily true. Because the Eden Alternative program promotes reorganizing staff away from a hierarchy model and into cooperative, self-empowered teams, studies have shown that staff turnover rates are greatly reduced at nursing homes in which the Eden Alternative is implemented. Overall use of medications needed for fighting infections has gone down. Also, residents have been documented as being less agitated, less irritable, and less depressed at these homes. |